Does the American health system over medicalise birth?

[Schooldil3ma]

A friend of mine is giving birth in America. She had an easy pregnancy in her country of residence, and arrived in USA at about 32 weeks. Jeez, she has had every test, multiple appointments, it's been almost all consuming. She's now in hospital ready to start labour, again so many interventions, she's been in about 3 days already.

Do you think she's just unlucky, or is the way it goes, especially as she's obviously paying?

Sure they are. 62% of U.K. are overweight, 25% obese, so only 3/10 in U.K. are a healthy weight….same as the US.

It is bonkers. It’s a half-assed, hand knitted cheapo option but it’s only women eh? Who cares.

You say that, but plenty of like it. I think it's great, I mean, it's hardly forced upon you. You can have an epidural if you like.

I did one gas water birth, one induction epidural. I loved both for different reasons.

Well, good for you. All those crazy women who can't bear the pain must be doing everything wrong, and it is just a toothache,. Somebody should have told me that after was I labour for three days with horrible pain. Next time I'll just visit my dentist.

At least we have a place to call just to get the baby weighed or small things that you may not need the gp for.

Correct me if I'm wrong, but my experience is the paediatrician does both of those things. I've said on previous threads I've given birth in both the US and the UK; in the US you go to the paediatrician for the health checks, and ours had a 24/7 nursing line you could call when you needed anything that didn't require the doctor's attention.

Both systems have pros and cons. All three of my DC's births were similar in terms of risk, and the one that went very badly was in the UK.

It’s AMAZING! They fill condoms with water, then freeze them, then you can lay them over your poor swollen bits and it feels like heaven!! The first time they brought me one, I was all WTAF. But now, I’m SOLD. They don’t go inside you… just making that clear!!

They are a thing🤣
I thought it must have been a typo but couldn't figure out what for!

The bad outcomes in the US are from mostly women who show up at the hospital in labor, never having any pre-natal care. A lot of the time they have been using drugs, drinking and have poor diets, not to mention problems not being caught in time. I have seen this myself in the inner-city and also heard it from a British trained mid-wife who had to take care of these women. She was appalled at what she had to deal with.

In the US if a woman goes to all her appointments, follows pre-natal care instructions, she will have a very good outcome because the care is great.

There's no home health visitors here, checking up on women who may be pregnant.

I addressed this in a post above.

You can get climate friendly gas and air now
www.newcastle-hospitals.nhs.uk/news/newcastle-hospitals-become-first-in-the-uk-to-use-climate-friendly-gas-and-air-during-labour/

The bad outcomes in the US are not caused by “bad” women as you imply but a shit healthcare system with care only as good as what you can pay for.

Why are many women getting no prenatal care? Because they’re one of the 32 million with no access to healthcare. How can these women “attend all their appointments and follow instructions” when they literally have no prenatal care through no fault of their own?

And what is an impact of poverty? The poor are at higher risk to use alcohol and drugs as coping mechanisms. The poor also cannot afford a “good diet”.

Poor women definitely cannot afford the $10,000 average cost of having a baby. They don’t even have access to an abortion…if they’re in a state where it is legal where will the $3,000 come from for an abortion? If they’re in a state where abortion is illegal…no abortion for them either.

I'm not sure how things would go if a woman arrived in the UK at 32 weeks pregnant, but I imagine it would involve some tests and multiple appointments fairly quickly. Medical records don't cross countries very well.

As for the US, it depends on where and what hospital, it varies a lot. In some areas, many things are medicalized more, birth being one of them, and in others it's not.

Also, gas & air is used in the US - it's just not part of the labour ward and more used in dentistry or for things like wart removal.

And blaming the US's poorer outcomes on solely the women's action is a great way to ignore the flaws in the system and rings a lot like those US politicians who go on about how the US's maternal and birth outcomes would be great if black women were removed from the stats.

I don't understand the backlash against medicalisation...death in childbirth and stillbirths were just par for the course not that many years ago. I'll take the science, thanks.

Medical abuse is a big reason, something pregnant girls and women are known to be at higher risk for and less likely than the already abysmal typical rates of getting it actually dealt with on either side of the Atlantic, even more for those disabled and/or of marginalized ethnicities (even when they go to all their appointments).

It also plays a major role in the anti-vax crowd and the previously mentioned freebirthers. When someone loses trust that HCPs have their best interest at heart and can get away with anything, and has horrific experience of the system failing to protect them at their most vulnerable, they can go really hard against any type for medicalisation and getting back from that has barriers, often compounded by poor science education that many areas of the US are well known for, but also in parts of the UK.

Here in the US we take our babies to their pediatrician for everything, not the family GP. In the inner city they have baby/children clinics where they have at least one pediatrician on staff.

I also remembered there are well baby clinics to monitor a baby's development.

If you want a excellent pregnancy/delivery care, care for your baby or child in the US, it is very available. You just have to want it.

Many US hospitals adopted the Dublin Method of induction which was developed in Holles Street, Dublin and dictates a dilation rate of 1cm per hour- less than that they give you drugs to move things along.

However in Holles Street every labouring woman has a midwife with her the whole time, and two during active labour. When the US imported the method, they dropped the midwife component. That’s a factor in their significantly higher caesarean outcomes.

Even in Romania they have paediatric GPs, after age 16 then they go to the regular GP. Odd we don't have that in the UK.

post birth, I recovered in my own room. I was brought iced condoms every couple of hours

I was imagining condoms with piped buttercream on them at first.. 🤣

That honestly surprises me!

I have walked round America and I have walked round the U.K. Sure there are fat people here but nothing at all like in America. Perhaps I am half blind 🤣

Nobody is ever worried about over medicalising any other life threatening procedure
we just hate women and think it’s a good right of passage to suffer
for some reason that they are pushed into and get no say about

@Prunel

They are though. We wouldn't put a POP on everyone who had a sprained ankle.
Suture a papercut.
Give everyone who has D&V IV fluid.

Generally we're good at weighing up the risks vs benefits of each treatment.

I think if your privately insured, yes it's slightly over the top but it's bloody amazing. If youre poor or not white then, not so good <understatement>

There are a lot of misconceptions on this thread as with all threads referencing life in the US.

There absolutely is a national professional set of norms, best practices and guidance followed by doctors and midwives.

On top of that, insurance companies are continuously honing best practices from the pov of cost benefit analysis.

I've given birth four times with my feet in stirrups. I didn't find it particularly frightful. Yes, it hurt.

It hurt exactly the same amount as the time I gave birth lying on my side but I didnt get varicose veins in my left groin from the stirrups.

The one time it didn't hurt as much was the delivery with the epidural.

I did have the option of a birthing pool for one delivery but I ended up on a bed because they didnt have time to get it prepped and filled before DC arrived.

I really appreciated getting a nice room afterwards each time, even when I was a public patient, with shower and loo ensure, the great food, the caring nurses who had time to answer my questions and the staff refilling water pitchers by the bedside.

@SparkyBlue your Dsis will bring her baby to the pediatrician for a two week newborn checkup, then again at 2, 4, and 6 months. The baby will be closely observed at all these checkups and will receive vaccinations at the 2, 4, and 6 month visits. There will be a schedule of further regular well baby checkups between 6 months and age 4, during which various booster vaccinations will be given. After that, the child will have once a year well child checkups as well as sick visits as needed.

Your Dsis will have a 6 week postpartum checkup. The doctor she sees will be part of the team she got to know during her pre natal care and delivery. They will discuss any concerns with breastfeeding, her recovery, contraception, exercise.. Any incision done during the delivery will be examined. She will be screened for PND.

I had a post partum nurse visit once. It wasn't really necessary. I had two older children at that point and knew the ropes. Maybe with my first, though I had all sorts of good advice from my mum, who was very pro breastfeeding.

I like the Irish system - I myself was weighed and measured by a lovely public health nurse in the Dublin suburb I grew up in. I think America could do with a public health nurse system. I remember reading about a trial of nurse visits to women who were identified as at risk for post partum problems before their deliveries. The problem with only assisting those at risk was that it stigmatised the entire concept, which is a shame.

Safer in what context? It's major surgery.

I've worked with nurses who have worked in the states and no the care isn't better. If fact the reason I knew them was they came back tot he UK because they didn't like the standard of lack of care they were forced to provide.

This is an interesting read

healthcare.utah.edu/the-scope/shows.php?shows=0_w7uql6a0

I've seen stats for births in US hospitals where no babies are born at certain holidays eg Xmas - now that doesn't happen by chance.

The hospital might not have maternity services fir a few days or, more likely, women due to give birth 25th December are induced.

@mimiraveile no, public and private patients alike get the same treatment. I've given birth with both private insurance and as a public patient. Same hospitals, same private rooms, same nursing care.

@Trivester
American midwives are stand alone professionals who have done further professional training and licensing exams after their RN training and a certain period of work in hospitals in labout and delivery. They are absolutely not just obstetrical nursing staff as you see in the UK.

They are far more highly qualified than British midwives who enter midwifery without the professional nursing education or background.

Laboring women in the US are attended by RNs, who are graduates of four years of education and training and who hold a BSc in nursing followed by professional licensing exams (to become registered nurses), and if working in labour and delivery they have expertise in that area.